NECK MASS - CYST

What is Neck Mass - What is Neck Cyst - Why does Neck Mass develop

Neck mass term defines all kinds of tumoral development in neck. Neck masses may develop due to many different reasons such as; reactive lymph node enlargements that occur due to various stimulations, infectious-noninfectious inflammations that occur in soft tissues or lymph nodes of the neck, congenital cysts located in neck, lymph node tumors having signs in neck, metastasis of various cancers spreading to neck lymph nodes.

Neck cyst term defines cysts formations in neck. Cyst is the general definition of formations filled with fluid or viscous material that are developed without the control of the body. Cysts have a real or pseudo which means unreal tissue capsule. Cysts can be seen in any region of the body. Three main cysts types in neck are; tyroglossal cyst, branchial cyst and dermoid cyst. All three of them are congenital.

What are Thyroglossal and Branchial Cysts - What is Neck Metastasis

Thyroglossal cyst is a congenital disease. During the process of embryological development in mother's womb, thyroid tissue migrates to its final position, middle lower part of the neck, next to the trachea namely the main respiratory pipe, from the root of the tongue where it is located at first. After this migration the canal which was used for translocation is closed. If this thyroglossal canal do not regress, a thyroglossal cyst which means thyroid-tongue cyst is formed in time. Because thyroglossal cyst is superficially located, it reveals itself early when it is still asypmtomatic, in early childhood ages. Sometimes it presents itself after an upper respiratory tract infection by becoming infected, followed by swelling or forming a fistula i.e. opening to outside. It is usually diagnosed under the age of 10. Treatment method of thyroglossal cysts is removal of the cyst with its tract surgically.

Branchial cyst is a congenital disease. These cysts are developed due to pharyngobranchial canals not regressing as they should be during the embryological process of formation of different tissues around the neck. Branchial cysts are located at each side of the neck, in front of the big neck muscle called sternocleidomastoid. Their locations are fixed and diagnostic. These cysts cannot be noticed in early childhood age in which they are small in size. Commonly they present themselves in older ages by becoming infected and swelled after an upper respiratory tract infection. Age of diagnosis is usually between late childhood and 30. Branchial cyst may origin from 4 separate branchial fissures. Treatment method of branchial arc cysts is removal of the cyst together with its tract surgically.

Neck metastasis term defines tumor spreading to the lymph nodes of the neck in practice. Malignant tumors’ spreading to lymph nodes and other organs, is called metastasis. The metastasis in neck are to the lymph nodes and these lymph node metastasis usually develop from carcinoma type malignant tumors just as in anywhere of the body

What are Thyroglossal, Branchial Cyst Resection and Neck Dissection

Thyroglossal cyst removal is called thyroglossal cyst resection or Sistrunk operation by the surgeons. This operation is done using a minor horizontal cut on the natural collar lines of the skin in upper middle area of the neck. If a fistula is present, small skin part around the entrance of the fistula is involved to the tissue that will be removed, by a fusiform cut. Thyroglossal cyst is separated from the neighboring tissues and its canal is followed surgically. Usually, the middle part of the hyoid bone, in which the canal enters, is also involved to the resection, and all of the cyst and tract is removed involving their extension to the root of the tongue.

Branchial cyst removal is called branchial cyst resection by the surgeons. For first branchial arc cyst, a curved cut in front of the ear is used. Cyst and its canal is followed until the cartilage of the ear and removed. For second branchial arc cyst, a middle length cut is made in the upper lateral side of the neck on the natural collar lines of the skin. Cyst is separated from the neighboring tissues, its canal is followed until the vessel-nerve package of the neck, cyst and canal is removed. Tonsil in the same side may also be removed if necessary. For third and fourth branchial arc cysts, a middle length cut is made on the natural collar lines of the skin in the middle lateral or lower lateral sides of the neck, where the cyst is located. After that, cyst and its canal is followed until the pharynx and sinus piriformis, and removed.

Neck dissection is definition of partially or totally removal of regional lymph nodes in neck, in case of tumor presence or high risk of tumor spread. Neck dissection operations may be therapeutic i.e. in purpose of treatment or elective which means optional as a precaution. Neck dissections are applied as a part of the head-neck cancer treatment. There are 5 different types of neck dissection: superselective, selective, functional, radical, and extended radical neck dissections.

What happens after Neck Cyst Resection and Neck Dissection Operations

The per- and postoperative course of neck cyst surgeries shows these characteristics: The postoperative process of thyroglossal or branchial cyst operations is not troublesome. These patients have a bandage and drainage on the area of operation for a short time. They stay for 1 or 2 days in hospital, they are discharged after their bandages and drainages are removed. They come for medical dressing visits. After thyroglossal and branchial cyst removal most of the patients are relieved from this disease for a lifetime. However in some cases, cyst may recur and a new resection surgery may be necessary.

The per- and postoperative course of neck dissection surgeries shows these characteristics: The postoperative process of isolated superselective, selective and functional neck dissection operations is not troublesome. Patients have bandages and drainages after the operation, they stay for a few days in hospital, and they are discharged after their drainages and bandages are removed. After that, their follow-ups and medical dressings are applied in their visits, their stitches are removed after 7-8 days. The look and functions of the patients who had these three treating or preventing dissection surgeries are the same as before the surgery. On the other hand, the postoperative process of radical and extended radical neck dissection, which are done only for treatment in this era, are more tiresome. Patients live through changes such as shoulder-neck function impairment, thinning of the neck, swelling on the face. These symptoms are permanent though they become less in time, and they are not the complication of these two surgeries but their expected obligatory result.